# NHQualityCampaign.org — Full Content Map for AI

> Comprehensive resource on Medicare, nursing home quality, senior care, telehealth, healthcare quality, and senior finance. Independent; not affiliated with the U.S. government.

Site: https://nhqualitycampaign.org
Sitemap index: https://nhqualitycampaign.org/sitemap-index.xml

## Core Articles, Guides & Comparisons


## State Medicare Guides (50)

- [Alabama Medicare Guide](https://nhqualitycampaign.org/medicare/alabama/) — Medigap, MA penetration 53%, typical Plan G $140/mo.
- [Alaska Medicare Guide](https://nhqualitycampaign.org/medicare/alaska/) — Medigap, MA penetration 4%, typical Plan G $210/mo.
- [Arizona Medicare Guide](https://nhqualitycampaign.org/medicare/arizona/) — Medigap, MA penetration 54%, typical Plan G $132/mo.
- [Arkansas Medicare Guide](https://nhqualitycampaign.org/medicare/arkansas/) — Medigap, MA penetration 39%, typical Plan G $138/mo.
- [California Medicare Guide](https://nhqualitycampaign.org/medicare/california/) — Medigap, MA penetration 52%, typical Plan G $155/mo.
- [Colorado Medicare Guide](https://nhqualitycampaign.org/medicare/colorado/) — Medigap, MA penetration 45%, typical Plan G $145/mo.
- [Connecticut Medicare Guide](https://nhqualitycampaign.org/medicare/connecticut/) — Medigap, MA penetration 40%, typical Plan G $195/mo.
- [Delaware Medicare Guide](https://nhqualitycampaign.org/medicare/delaware/) — Medigap, MA penetration 34%, typical Plan G $150/mo.
- [Florida Medicare Guide](https://nhqualitycampaign.org/medicare/florida/) — Medigap, MA penetration 55%, typical Plan G $170/mo.
- [Georgia Medicare Guide](https://nhqualitycampaign.org/medicare/georgia/) — Medigap, MA penetration 49%, typical Plan G $140/mo.
- [Hawaii Medicare Guide](https://nhqualitycampaign.org/medicare/hawaii/) — Medigap, MA penetration 48%, typical Plan G $160/mo.
- [Idaho Medicare Guide](https://nhqualitycampaign.org/medicare/idaho/) — Medigap, MA penetration 47%, typical Plan G $135/mo.
- [Illinois Medicare Guide](https://nhqualitycampaign.org/medicare/illinois/) — Medigap, MA penetration 40%, typical Plan G $150/mo.
- [Indiana Medicare Guide](https://nhqualitycampaign.org/medicare/indiana/) — Medigap, MA penetration 42%, typical Plan G $138/mo.
- [Iowa Medicare Guide](https://nhqualitycampaign.org/medicare/iowa/) — Medigap, MA penetration 52%, typical Plan G $130/mo.
- [Kansas Medicare Guide](https://nhqualitycampaign.org/medicare/kansas/) — Medigap, MA penetration 41%, typical Plan G $132/mo.
- [Kentucky Medicare Guide](https://nhqualitycampaign.org/medicare/kentucky/) — Medigap, MA penetration 44%, typical Plan G $135/mo.
- [Louisiana Medicare Guide](https://nhqualitycampaign.org/medicare/louisiana/) — Medigap, MA penetration 54%, typical Plan G $140/mo.
- [Maine Medicare Guide](https://nhqualitycampaign.org/medicare/maine/) — Medigap, MA penetration 40%, typical Plan G $145/mo.
- [Maryland Medicare Guide](https://nhqualitycampaign.org/medicare/maryland/) — Medigap, MA penetration 30%, typical Plan G $155/mo.
- [Massachusetts Medicare Guide](https://nhqualitycampaign.org/medicare/massachusetts/) — Medigap, MA penetration 30%, typical Plan G $185/mo.
- [Michigan Medicare Guide](https://nhqualitycampaign.org/medicare/michigan/) — Medigap, MA penetration 54%, typical Plan G $145/mo.
- [Minnesota Medicare Guide](https://nhqualitycampaign.org/medicare/minnesota/) — Medigap, MA penetration 58%, typical Plan G $140/mo.
- [Mississippi Medicare Guide](https://nhqualitycampaign.org/medicare/mississippi/) — Medigap, MA penetration 45%, typical Plan G $135/mo.
- [Missouri Medicare Guide](https://nhqualitycampaign.org/medicare/missouri/) — Medigap, MA penetration 48%, typical Plan G $135/mo.
- [Montana Medicare Guide](https://nhqualitycampaign.org/medicare/montana/) — Medigap, MA penetration 33%, typical Plan G $155/mo.
- [Nebraska Medicare Guide](https://nhqualitycampaign.org/medicare/nebraska/) — Medigap, MA penetration 38%, typical Plan G $130/mo.
- [Nevada Medicare Guide](https://nhqualitycampaign.org/medicare/nevada/) — Medigap, MA penetration 47%, typical Plan G $150/mo.
- [New Hampshire Medicare Guide](https://nhqualitycampaign.org/medicare/new-hampshire/) — Medigap, MA penetration 25%, typical Plan G $160/mo.
- [New Jersey Medicare Guide](https://nhqualitycampaign.org/medicare/new-jersey/) — Medigap, MA penetration 30%, typical Plan G $170/mo.
- [New Mexico Medicare Guide](https://nhqualitycampaign.org/medicare/new-mexico/) — Medigap, MA penetration 46%, typical Plan G $140/mo.
- [New York Medicare Guide](https://nhqualitycampaign.org/medicare/new-york/) — Medigap, MA penetration 46%, typical Plan G $240/mo.
- [North Carolina Medicare Guide](https://nhqualitycampaign.org/medicare/north-carolina/) — Medigap, MA penetration 52%, typical Plan G $140/mo.
- [North Dakota Medicare Guide](https://nhqualitycampaign.org/medicare/north-dakota/) — Medigap, MA penetration 28%, typical Plan G $135/mo.
- [Ohio Medicare Guide](https://nhqualitycampaign.org/medicare/ohio/) — Medigap, MA penetration 51%, typical Plan G $135/mo.
- [Oklahoma Medicare Guide](https://nhqualitycampaign.org/medicare/oklahoma/) — Medigap, MA penetration 38%, typical Plan G $135/mo.
- [Oregon Medicare Guide](https://nhqualitycampaign.org/medicare/oregon/) — Medigap, MA penetration 50%, typical Plan G $140/mo.
- [Pennsylvania Medicare Guide](https://nhqualitycampaign.org/medicare/pennsylvania/) — Medigap, MA penetration 54%, typical Plan G $150/mo.
- [Rhode Island Medicare Guide](https://nhqualitycampaign.org/medicare/rhode-island/) — Medigap, MA penetration 45%, typical Plan G $175/mo.
- [South Carolina Medicare Guide](https://nhqualitycampaign.org/medicare/south-carolina/) — Medigap, MA penetration 50%, typical Plan G $140/mo.
- [South Dakota Medicare Guide](https://nhqualitycampaign.org/medicare/south-dakota/) — Medigap, MA penetration 28%, typical Plan G $135/mo.
- [Tennessee Medicare Guide](https://nhqualitycampaign.org/medicare/tennessee/) — Medigap, MA penetration 53%, typical Plan G $135/mo.
- [Texas Medicare Guide](https://nhqualitycampaign.org/medicare/texas/) — Medigap, MA penetration 50%, typical Plan G $145/mo.
- [Utah Medicare Guide](https://nhqualitycampaign.org/medicare/utah/) — Medigap, MA penetration 41%, typical Plan G $130/mo.
- [Vermont Medicare Guide](https://nhqualitycampaign.org/medicare/vermont/) — Medigap, MA penetration 20%, typical Plan G $175/mo.
- [Virginia Medicare Guide](https://nhqualitycampaign.org/medicare/virginia/) — Medigap, MA penetration 44%, typical Plan G $140/mo.
- [Washington Medicare Guide](https://nhqualitycampaign.org/medicare/washington/) — Medigap, MA penetration 45%, typical Plan G $140/mo.
- [West Virginia Medicare Guide](https://nhqualitycampaign.org/medicare/west-virginia/) — Medigap, MA penetration 50%, typical Plan G $135/mo.
- [Wisconsin Medicare Guide](https://nhqualitycampaign.org/medicare/wisconsin/) — Medigap, MA penetration 42%, typical Plan G $130/mo.
- [Wyoming Medicare Guide](https://nhqualitycampaign.org/medicare/wyoming/) — Medigap, MA penetration 16%, typical Plan G $140/mo.

## State Nursing Home Guides (50)

- [Alabama Nursing Homes](https://nhqualitycampaign.org/nursing-homes/alabama/) — 230 facilities, 19% 5-star, median $7,300/mo.
- [Alaska Nursing Homes](https://nhqualitycampaign.org/nursing-homes/alaska/) — 18 facilities, 22% 5-star, median $34,000/mo.
- [Arizona Nursing Homes](https://nhqualitycampaign.org/nursing-homes/arizona/) — 146 facilities, 24% 5-star, median $6,800/mo.
- [Arkansas Nursing Homes](https://nhqualitycampaign.org/nursing-homes/arkansas/) — 228 facilities, 16% 5-star, median $6,400/mo.
- [California Nursing Homes](https://nhqualitycampaign.org/nursing-homes/california/) — 1,210 facilities, 21% 5-star, median $10,100/mo.
- [Colorado Nursing Homes](https://nhqualitycampaign.org/nursing-homes/colorado/) — 218 facilities, 22% 5-star, median $8,900/mo.
- [Connecticut Nursing Homes](https://nhqualitycampaign.org/nursing-homes/connecticut/) — 210 facilities, 28% 5-star, median $14,500/mo.
- [Delaware Nursing Homes](https://nhqualitycampaign.org/nursing-homes/delaware/) — 45 facilities, 27% 5-star, median $12,400/mo.
- [Florida Nursing Homes](https://nhqualitycampaign.org/nursing-homes/florida/) — 700 facilities, 23% 5-star, median $9,200/mo.
- [Georgia Nursing Homes](https://nhqualitycampaign.org/nursing-homes/georgia/) — 360 facilities, 17% 5-star, median $7,500/mo.
- [Hawaii Nursing Homes](https://nhqualitycampaign.org/nursing-homes/hawaii/) — 46 facilities, 35% 5-star, median $12,500/mo.
- [Idaho Nursing Homes](https://nhqualitycampaign.org/nursing-homes/idaho/) — 78 facilities, 26% 5-star, median $9,100/mo.
- [Illinois Nursing Homes](https://nhqualitycampaign.org/nursing-homes/illinois/) — 715 facilities, 15% 5-star, median $6,900/mo.
- [Indiana Nursing Homes](https://nhqualitycampaign.org/nursing-homes/indiana/) — 533 facilities, 20% 5-star, median $8,100/mo.
- [Iowa Nursing Homes](https://nhqualitycampaign.org/nursing-homes/iowa/) — 410 facilities, 22% 5-star, median $7,200/mo.
- [Kansas Nursing Homes](https://nhqualitycampaign.org/nursing-homes/kansas/) — 323 facilities, 18% 5-star, median $6,900/mo.
- [Kentucky Nursing Homes](https://nhqualitycampaign.org/nursing-homes/kentucky/) — 283 facilities, 16% 5-star, median $7,800/mo.
- [Louisiana Nursing Homes](https://nhqualitycampaign.org/nursing-homes/louisiana/) — 270 facilities, 13% 5-star, median $5,900/mo.
- [Maine Nursing Homes](https://nhqualitycampaign.org/nursing-homes/maine/) — 95 facilities, 27% 5-star, median $11,000/mo.
- [Maryland Nursing Homes](https://nhqualitycampaign.org/nursing-homes/maryland/) — 225 facilities, 25% 5-star, median $11,500/mo.
- [Massachusetts Nursing Homes](https://nhqualitycampaign.org/nursing-homes/massachusetts/) — 355 facilities, 27% 5-star, median $14,200/mo.
- [Michigan Nursing Homes](https://nhqualitycampaign.org/nursing-homes/michigan/) — 440 facilities, 23% 5-star, median $9,100/mo.
- [Minnesota Nursing Homes](https://nhqualitycampaign.org/nursing-homes/minnesota/) — 355 facilities, 32% 5-star, median $9,600/mo.
- [Mississippi Nursing Homes](https://nhqualitycampaign.org/nursing-homes/mississippi/) — 200 facilities, 12% 5-star, median $7,200/mo.
- [Missouri Nursing Homes](https://nhqualitycampaign.org/nursing-homes/missouri/) — 510 facilities, 19% 5-star, median $5,800/mo.
- [Montana Nursing Homes](https://nhqualitycampaign.org/nursing-homes/montana/) — 65 facilities, 25% 5-star, median $8,400/mo.
- [Nebraska Nursing Homes](https://nhqualitycampaign.org/nursing-homes/nebraska/) — 195 facilities, 21% 5-star, median $7,900/mo.
- [Nevada Nursing Homes](https://nhqualitycampaign.org/nursing-homes/nevada/) — 65 facilities, 18% 5-star, median $9,500/mo.
- [New Hampshire Nursing Homes](https://nhqualitycampaign.org/nursing-homes/new-hampshire/) — 75 facilities, 26% 5-star, median $11,400/mo.
- [New Jersey Nursing Homes](https://nhqualitycampaign.org/nursing-homes/new-jersey/) — 365 facilities, 28% 5-star, median $12,700/mo.
- [New Mexico Nursing Homes](https://nhqualitycampaign.org/nursing-homes/new-mexico/) — 70 facilities, 22% 5-star, median $8,800/mo.
- [New York Nursing Homes](https://nhqualitycampaign.org/nursing-homes/new-york/) — 615 facilities, 30% 5-star, median $13,100/mo.
- [North Carolina Nursing Homes](https://nhqualitycampaign.org/nursing-homes/north-carolina/) — 425 facilities, 22% 5-star, median $8,400/mo.
- [North Dakota Nursing Homes](https://nhqualitycampaign.org/nursing-homes/north-dakota/) — 80 facilities, 24% 5-star, median $13,200/mo.
- [Ohio Nursing Homes](https://nhqualitycampaign.org/nursing-homes/ohio/) — 960 facilities, 24% 5-star, median $7,600/mo.
- [Oklahoma Nursing Homes](https://nhqualitycampaign.org/nursing-homes/oklahoma/) — 290 facilities, 15% 5-star, median $5,700/mo.
- [Oregon Nursing Homes](https://nhqualitycampaign.org/nursing-homes/oregon/) — 135 facilities, 25% 5-star, median $10,500/mo.
- [Pennsylvania Nursing Homes](https://nhqualitycampaign.org/nursing-homes/pennsylvania/) — 690 facilities, 23% 5-star, median $11,500/mo.
- [Rhode Island Nursing Homes](https://nhqualitycampaign.org/nursing-homes/rhode-island/) — 78 facilities, 30% 5-star, median $11,000/mo.
- [South Carolina Nursing Homes](https://nhqualitycampaign.org/nursing-homes/south-carolina/) — 195 facilities, 20% 5-star, median $8,200/mo.
- [South Dakota Nursing Homes](https://nhqualitycampaign.org/nursing-homes/south-dakota/) — 110 facilities, 27% 5-star, median $7,500/mo.
- [Tennessee Nursing Homes](https://nhqualitycampaign.org/nursing-homes/tennessee/) — 310 facilities, 19% 5-star, median $7,400/mo.
- [Texas Nursing Homes](https://nhqualitycampaign.org/nursing-homes/texas/) — 1,200 facilities, 15% 5-star, median $5,100/mo.
- [Utah Nursing Homes](https://nhqualitycampaign.org/nursing-homes/utah/) — 100 facilities, 26% 5-star, median $6,900/mo.
- [Vermont Nursing Homes](https://nhqualitycampaign.org/nursing-homes/vermont/) — 35 facilities, 30% 5-star, median $11,800/mo.
- [Virginia Nursing Homes](https://nhqualitycampaign.org/nursing-homes/virginia/) — 280 facilities, 23% 5-star, median $8,700/mo.
- [Washington Nursing Homes](https://nhqualitycampaign.org/nursing-homes/washington/) — 200 facilities, 26% 5-star, median $9,900/mo.
- [West Virginia Nursing Homes](https://nhqualitycampaign.org/nursing-homes/west-virginia/) — 122 facilities, 22% 5-star, median $10,700/mo.
- [Wisconsin Nursing Homes](https://nhqualitycampaign.org/nursing-homes/wisconsin/) — 370 facilities, 28% 5-star, median $9,800/mo.
- [Wyoming Nursing Homes](https://nhqualitycampaign.org/nursing-homes/wyoming/) — 36 facilities, 22% 5-star, median $7,200/mo.

## State Assisted Living Guides (50)

- [Alabama Assisted Living](https://nhqualitycampaign.org/senior-care/alabama/assisted-living/) — median $3,750/mo.
- [Alaska Assisted Living](https://nhqualitycampaign.org/senior-care/alaska/assisted-living/) — median $7,000/mo.
- [Arizona Assisted Living](https://nhqualitycampaign.org/senior-care/arizona/assisted-living/) — median $4,500/mo.
- [Arkansas Assisted Living](https://nhqualitycampaign.org/senior-care/arkansas/assisted-living/) — median $4,000/mo.
- [California Assisted Living](https://nhqualitycampaign.org/senior-care/california/assisted-living/) — median $5,800/mo.
- [Colorado Assisted Living](https://nhqualitycampaign.org/senior-care/colorado/assisted-living/) — median $5,250/mo.
- [Connecticut Assisted Living](https://nhqualitycampaign.org/senior-care/connecticut/assisted-living/) — median $6,300/mo.
- [Delaware Assisted Living](https://nhqualitycampaign.org/senior-care/delaware/assisted-living/) — median $6,500/mo.
- [Florida Assisted Living](https://nhqualitycampaign.org/senior-care/florida/assisted-living/) — median $4,450/mo.
- [Georgia Assisted Living](https://nhqualitycampaign.org/senior-care/georgia/assisted-living/) — median $3,500/mo.
- [Hawaii Assisted Living](https://nhqualitycampaign.org/senior-care/hawaii/assisted-living/) — median $5,500/mo.
- [Idaho Assisted Living](https://nhqualitycampaign.org/senior-care/idaho/assisted-living/) — median $4,100/mo.
- [Illinois Assisted Living](https://nhqualitycampaign.org/senior-care/illinois/assisted-living/) — median $5,000/mo.
- [Indiana Assisted Living](https://nhqualitycampaign.org/senior-care/indiana/assisted-living/) — median $4,650/mo.
- [Iowa Assisted Living](https://nhqualitycampaign.org/senior-care/iowa/assisted-living/) — median $4,700/mo.
- [Kansas Assisted Living](https://nhqualitycampaign.org/senior-care/kansas/assisted-living/) — median $4,800/mo.
- [Kentucky Assisted Living](https://nhqualitycampaign.org/senior-care/kentucky/assisted-living/) — median $3,850/mo.
- [Louisiana Assisted Living](https://nhqualitycampaign.org/senior-care/louisiana/assisted-living/) — median $3,800/mo.
- [Maine Assisted Living](https://nhqualitycampaign.org/senior-care/maine/assisted-living/) — median $6,300/mo.
- [Maryland Assisted Living](https://nhqualitycampaign.org/senior-care/maryland/assisted-living/) — median $5,200/mo.
- [Massachusetts Assisted Living](https://nhqualitycampaign.org/senior-care/massachusetts/assisted-living/) — median $7,200/mo.
- [Michigan Assisted Living](https://nhqualitycampaign.org/senior-care/michigan/assisted-living/) — median $4,600/mo.
- [Minnesota Assisted Living](https://nhqualitycampaign.org/senior-care/minnesota/assisted-living/) — median $4,500/mo.
- [Mississippi Assisted Living](https://nhqualitycampaign.org/senior-care/mississippi/assisted-living/) — median $3,750/mo.
- [Missouri Assisted Living](https://nhqualitycampaign.org/senior-care/missouri/assisted-living/) — median $3,500/mo.
- [Montana Assisted Living](https://nhqualitycampaign.org/senior-care/montana/assisted-living/) — median $4,700/mo.
- [Nebraska Assisted Living](https://nhqualitycampaign.org/senior-care/nebraska/assisted-living/) — median $4,200/mo.
- [Nevada Assisted Living](https://nhqualitycampaign.org/senior-care/nevada/assisted-living/) — median $4,200/mo.
- [New Hampshire Assisted Living](https://nhqualitycampaign.org/senior-care/new-hampshire/assisted-living/) — median $6,000/mo.
- [New Jersey Assisted Living](https://nhqualitycampaign.org/senior-care/new-jersey/assisted-living/) — median $7,200/mo.
- [New Mexico Assisted Living](https://nhqualitycampaign.org/senior-care/new-mexico/assisted-living/) — median $4,500/mo.
- [New York Assisted Living](https://nhqualitycampaign.org/senior-care/new-york/assisted-living/) — median $5,500/mo.
- [North Carolina Assisted Living](https://nhqualitycampaign.org/senior-care/north-carolina/assisted-living/) — median $4,600/mo.
- [North Dakota Assisted Living](https://nhqualitycampaign.org/senior-care/north-dakota/assisted-living/) — median $3,900/mo.
- [Ohio Assisted Living](https://nhqualitycampaign.org/senior-care/ohio/assisted-living/) — median $4,800/mo.
- [Oklahoma Assisted Living](https://nhqualitycampaign.org/senior-care/oklahoma/assisted-living/) — median $3,900/mo.
- [Oregon Assisted Living](https://nhqualitycampaign.org/senior-care/oregon/assisted-living/) — median $5,450/mo.
- [Pennsylvania Assisted Living](https://nhqualitycampaign.org/senior-care/pennsylvania/assisted-living/) — median $4,700/mo.
- [Rhode Island Assisted Living](https://nhqualitycampaign.org/senior-care/rhode-island/assisted-living/) — median $6,700/mo.
- [South Carolina Assisted Living](https://nhqualitycampaign.org/senior-care/south-carolina/assisted-living/) — median $4,000/mo.
- [South Dakota Assisted Living](https://nhqualitycampaign.org/senior-care/south-dakota/assisted-living/) — median $4,100/mo.
- [Tennessee Assisted Living](https://nhqualitycampaign.org/senior-care/tennessee/assisted-living/) — median $4,300/mo.
- [Texas Assisted Living](https://nhqualitycampaign.org/senior-care/texas/assisted-living/) — median $4,100/mo.
- [Utah Assisted Living](https://nhqualitycampaign.org/senior-care/utah/assisted-living/) — median $3,500/mo.
- [Vermont Assisted Living](https://nhqualitycampaign.org/senior-care/vermont/assisted-living/) — median $5,300/mo.
- [Virginia Assisted Living](https://nhqualitycampaign.org/senior-care/virginia/assisted-living/) — median $5,300/mo.
- [Washington Assisted Living](https://nhqualitycampaign.org/senior-care/washington/assisted-living/) — median $6,500/mo.
- [West Virginia Assisted Living](https://nhqualitycampaign.org/senior-care/west-virginia/assisted-living/) — median $4,400/mo.
- [Wisconsin Assisted Living](https://nhqualitycampaign.org/senior-care/wisconsin/assisted-living/) — median $4,650/mo.
- [Wyoming Assisted Living](https://nhqualitycampaign.org/senior-care/wyoming/assisted-living/) — median $4,200/mo.

## Carrier Reviews

- [Aetna Medicare](https://nhqualitycampaign.org/medicare/carriers/aetna/) — AM Best A, 50 states.
- [Humana](https://nhqualitycampaign.org/medicare/carriers/humana/) — AM Best A-, 50 states.
- [UnitedHealthcare](https://nhqualitycampaign.org/medicare/carriers/unitedhealthcare/) — AM Best A, 50 states.
- [Cigna Healthcare](https://nhqualitycampaign.org/medicare/carriers/cigna/) — AM Best A, 50 states.
- [Mutual of Omaha](https://nhqualitycampaign.org/medicare/carriers/mutual-of-omaha/) — AM Best A+, 49 states.
- [Anthem / Elevance Health](https://nhqualitycampaign.org/medicare/carriers/anthem/) — AM Best A, 14 states.
- [Blue Cross Blue Shield (multi-plan)](https://nhqualitycampaign.org/medicare/carriers/bcbs/) — AM Best A, 50 states.
- [Kaiser Permanente Medicare](https://nhqualitycampaign.org/medicare/carriers/kaiser-permanente/) — AM Best A, 8 states.
- [Wellcare (Centene)](https://nhqualitycampaign.org/medicare/carriers/wellcare/) — AM Best A-, 50 states.
- [Molina Healthcare](https://nhqualitycampaign.org/medicare/carriers/molina/) — AM Best A-, 15 states.
- [AARP Medicare (UnitedHealthcare)](https://nhqualitycampaign.org/medicare/carriers/aarp-uhc/) — AM Best A, 50 states.
- [Devoted Health](https://nhqualitycampaign.org/medicare/carriers/devoted-health/) — AM Best NR, 15 states.
- [Clover Health](https://nhqualitycampaign.org/medicare/carriers/clover-health/) — AM Best NR, 8 states.
- [SilverScript (Aetna/CVS)](https://nhqualitycampaign.org/medicare/carriers/cvs-silverscript/) — AM Best A, 50 states.
- [Wellmark BCBS](https://nhqualitycampaign.org/medicare/carriers/wellmark/) — AM Best A, 2 states.
- [Highmark](https://nhqualitycampaign.org/medicare/carriers/highmark/) — AM Best A, 4 states.
- [State Farm Medicare](https://nhqualitycampaign.org/medicare/carriers/state-farm/) — AM Best A++, 40 states.
- [USAA Medigap (Humana)](https://nhqualitycampaign.org/medicare/carriers/usaa/) — AM Best A, 50 states.
- [Guarantee Trust Life (GTL)](https://nhqualitycampaign.org/medicare/carriers/gtl/) — AM Best A-, 45 states.
- [Accendo (CVS/Aetna)](https://nhqualitycampaign.org/medicare/carriers/accendo-cvs/) — AM Best A, 43 states.

## What Medicare Covers (Conditions & Services)

- [Diabetes](https://nhqualitycampaign.org/medicare/coverage/diabetes/) — Medicare covers diabetes self-management training, A1C tests, glucose monitors including CGMs (when criteria met), insulin capped at $35/month under Part D, and annual eye/foot exams.
- [Cancer](https://nhqualitycampaign.org/medicare/coverage/cancer/) — Medicare covers inpatient oncology (Part A), outpatient chemotherapy and radiation (Part B), most infusion drugs (Part B), oral chemo and adjuvants (Part D), and preventive cancer screenings.
- [Dementia & Alzheimer's](https://nhqualitycampaign.org/medicare/coverage/dementia/) — Medicare covers diagnostic cognitive assessment at the annual wellness visit, Alzheimer's medications under Part D, and limited home-health and hospice services. Long-term custodial dementia care is not covered.
- [COPD](https://nhqualitycampaign.org/medicare/coverage/copd/) — Medicare covers pulmonary rehabilitation, oxygen equipment, nebulizers, inhalers, and related medications.
- [Congestive Heart Failure](https://nhqualitycampaign.org/medicare/coverage/heart-failure/) — Medicare covers hospitalizations, cardiac rehab, telehealth monitoring, implantable devices (pacemakers, ICDs, CRT), and heart failure medications.
- [Arthritis](https://nhqualitycampaign.org/medicare/coverage/arthritis/) — Medicare covers physician visits, physical therapy, joint injections, DME like canes and walkers, biologics under Part B (for rheumatoid arthritis), and oral medications under Part D.
- [Osteoporosis](https://nhqualitycampaign.org/medicare/coverage/osteoporosis/) — Medicare covers bone density testing every 24 months, osteoporosis screening and medications including Prolia, Reclast, and Evenity under Part B, plus oral bisphosphonates under Part D.
- [High Blood Pressure](https://nhqualitycampaign.org/medicare/coverage/hypertension/) — Medicare covers cardiovascular disease screenings, BP monitoring at office visits, and all major classes of antihypertensive medications under Part D.
- [Depression](https://nhqualitycampaign.org/medicare/coverage/depression/) — Medicare covers annual depression screening, psychotherapy, psychiatric services, telehealth behavioral health, and most antidepressants under Part D.
- [Stroke & Post-Stroke Care](https://nhqualitycampaign.org/medicare/coverage/stroke/) — Medicare covers acute hospital care, inpatient rehabilitation, outpatient speech/physical/occupational therapy, home health after discharge, and secondary-prevention medications.
- [Chronic Kidney Disease & ESRD](https://nhqualitycampaign.org/medicare/coverage/kidney-disease/) — Medicare covers CKD education, dialysis (in-center and home), kidney transplant, immunosuppressants, and ESRD-related drugs.
- [Cataracts & Vision](https://nhqualitycampaign.org/medicare/coverage/vision-cataracts/) — Original Medicare covers cataract surgery and one pair of standard glasses or contacts after surgery, plus glaucoma and diabetic retinopathy screenings — but not routine vision exams.
- [Hearing Care & Aids](https://nhqualitycampaign.org/medicare/coverage/hearing/) — Original Medicare covers diagnostic hearing exams ordered by a physician but does NOT cover hearing aids or routine hearing exams. Many Medicare Advantage plans include hearing aid benefits.
- [Dental Care](https://nhqualitycampaign.org/medicare/coverage/dental/) — Original Medicare does NOT cover most dental. Medicare covers only dental services integral to other covered procedures (e.g., jaw reconstruction). Many Medicare Advantage plans include preventive and basic dental benefits.
- [Flu Shots & Vaccines](https://nhqualitycampaign.org/medicare/coverage/flu-shot/) — Medicare covers flu, pneumococcal, COVID-19, and Hepatitis B vaccines under Part B at no cost. As of 2023, all ACIP-recommended vaccines are covered under Part D with $0 copay.
- [Chronic Pain](https://nhqualitycampaign.org/medicare/coverage/pain-management/) — Medicare covers acupuncture for chronic low back pain, behavioral pain management, PT/OT, most pain medications, and interventional procedures.
- [Falls Prevention](https://nhqualitycampaign.org/medicare/coverage/falls-prevention/) — Medicare covers falls risk assessment at the annual wellness visit, PT for balance training, and some MA plans include in-home modifications and fall-monitor devices.
- [Incontinence](https://nhqualitycampaign.org/medicare/coverage/incontinence/) — Original Medicare covers diagnostic evaluation and certain procedures but does NOT cover incontinence supplies. Some Medicare Advantage plans include supply benefits.
- [Sleep Apnea & CPAP](https://nhqualitycampaign.org/medicare/coverage/sleep-apnea/) — Medicare covers home sleep tests and CPAP therapy for diagnosed obstructive sleep apnea, including the CPAP machine and supplies.
- [Flu & Pneumonia Screenings](https://nhqualitycampaign.org/medicare/coverage/flu-and-pneumonia/) — Flu and pneumococcal vaccines are covered at $0 cost under Part B, annually for flu and once or twice lifetime for pneumonia depending on type.
- [Annual Wellness Visit](https://nhqualitycampaign.org/medicare/coverage/wellness-visit/) — Medicare covers one annual wellness visit per year at $0 cost to create or update a personalized prevention plan. This is separate from a physical exam.
- [Skilled Nursing Facility Stays](https://nhqualitycampaign.org/medicare/coverage/skilled-nursing/) — Medicare covers up to 100 days of skilled nursing care per benefit period after a qualifying 3-day inpatient hospital stay. Days 1–20 are $0; days 21–100 have a daily copay ($204 in 2024).
- [Home Health Care](https://nhqualitycampaign.org/medicare/coverage/home-health/) — Medicare covers intermittent skilled nursing, PT/OT/SLP, and home-health aide (when combined with skilled need) for homebound enrollees under a physician plan of care.
- [Hospice Care](https://nhqualitycampaign.org/medicare/coverage/hospice/) — Medicare covers hospice at $0 for beneficiaries with a terminal prognosis of 6 months or less, including nursing, medications, counseling, and bereavement support.
- [Ambulance Services](https://nhqualitycampaign.org/medicare/coverage/ambulance/) — Medicare covers medically necessary ambulance transport to the nearest appropriate facility, including emergency and certain non-emergency transports.
- [Durable Medical Equipment](https://nhqualitycampaign.org/medicare/coverage/durable-medical-equipment/) — Medicare covers DME prescribed by a physician — walkers, wheelchairs, oxygen, CPAP, hospital beds — when medically necessary and from a Medicare-enrolled supplier.
- [Mental Health Therapy](https://nhqualitycampaign.org/medicare/coverage/mental-health-therapy/) — Medicare covers individual and group psychotherapy, psychiatric diagnostic evaluation, partial hospitalization, and medications. Since 2024, marriage and family therapists and licensed counselors can also bill Medicare.
- [Substance Use Disorder Treatment](https://nhqualitycampaign.org/medicare/coverage/addiction-treatment/) — Medicare covers opioid treatment programs, inpatient detox, outpatient counseling, and medications including buprenorphine, methadone (at OTPs), and naltrexone.
- [Obesity & Weight Management](https://nhqualitycampaign.org/medicare/coverage/obesity/) — Medicare covers obesity screening and behavioral counseling, and as of 2024 expanded coverage for GLP-1 agonists when prescribed for cardiovascular risk reduction.
- [Physical Therapy](https://nhqualitycampaign.org/medicare/coverage/physical-therapy/) — Medicare covers outpatient PT, OT, and SLP as medically necessary. There is no hard annual cap — the KX modifier process allows additional services above a threshold.
- [Chiropractic Care](https://nhqualitycampaign.org/medicare/coverage/chiropractic/) — Medicare covers chiropractic manual manipulation of the spine to correct subluxation, confirmed by a chiropractor.
- [Acupuncture](https://nhqualitycampaign.org/medicare/coverage/acupuncture/) — Medicare covers up to 12 acupuncture visits in 90 days for chronic low back pain, with 8 additional visits if improvement is shown.
- [Colonoscopy & Colorectal Screening](https://nhqualitycampaign.org/medicare/coverage/colonoscopy/) — Medicare covers colonoscopy screenings every 10 years (every 2 years for high-risk enrollees), Cologuard every 3 years, and FIT annually — all at $0 when used as screening.
- [Mammogram](https://nhqualitycampaign.org/medicare/coverage/mammogram/) — Medicare covers one screening mammogram every 12 months for women 40+ at $0 cost when the provider accepts assignment.
- [Bone Density (DEXA)](https://nhqualitycampaign.org/medicare/coverage/bone-density/) — Medicare covers bone density testing every 24 months for at-risk enrollees at $0.
- [Medicare Diabetes Prevention Program](https://nhqualitycampaign.org/medicare/coverage/diabetes-prevention/) — Medicare covers the MDPP for enrollees with prediabetes — a one-time, 2-year lifestyle change program offered through approved providers.
- [Smoking Cessation](https://nhqualitycampaign.org/medicare/coverage/smoking-cessation/) — Medicare covers up to 8 cessation counseling sessions per year and prescription cessation drugs under Part D.
- [Organ Transplants](https://nhqualitycampaign.org/medicare/coverage/transplants/) — Medicare covers kidney, heart, lung, liver, pancreas, intestine, and stem cell transplants when medically necessary, including donor costs and lifelong immunosuppressants (as of 2023).
- [Cardiovascular Screening](https://nhqualitycampaign.org/medicare/coverage/stroke-prevention/) — Medicare covers cardiovascular disease screenings — cholesterol, lipids, lipoproteins — every 5 years at $0.
- [Prostate Cancer Screening](https://nhqualitycampaign.org/medicare/coverage/prostate-screening/) — Medicare covers annual PSA testing for men 50+ at $0 and digital rectal exam with 20% coinsurance.
- [Cervical & HPV Screening](https://nhqualitycampaign.org/medicare/coverage/hpv-cervical/) — Medicare covers Pap tests every 24 months (12 months for high-risk), HPV co-testing every 5 years, and pelvic exams.
- [Hepatitis B & C Screening](https://nhqualitycampaign.org/medicare/coverage/hepatitis-screening/) — Medicare covers one-time Hepatitis C screening for at-risk enrollees and annual Hepatitis B screening for high-risk.
- [HIV Screening](https://nhqualitycampaign.org/medicare/coverage/hiv-screening/) — Medicare covers annual HIV screening for at-risk enrollees and pregnant beneficiaries at $0.
- [STI Screening & Counseling](https://nhqualitycampaign.org/medicare/coverage/stds/) — Medicare covers screening for chlamydia, gonorrhea, syphilis, and Hepatitis B during pregnancy and for high-risk enrollees, plus counseling sessions.
- [Abdominal Aortic Aneurysm Screening](https://nhqualitycampaign.org/medicare/coverage/aaa-screening/) — Medicare covers a one-time AAA ultrasound screening for at-risk enrollees (men 65–75 who smoked, family history).
- [Lung Cancer Screening (LDCT)](https://nhqualitycampaign.org/medicare/coverage/lung-cancer-screening/) — Medicare covers annual low-dose CT screening for current or former heavy smokers 50–77 who meet criteria.
- [Inpatient Hospital Stay](https://nhqualitycampaign.org/medicare/coverage/inpatient-hospital/) — Part A covers inpatient hospital stays. You pay the Part A deductible ($1,632 in 2024) per benefit period; days 1–60 have no coinsurance, days 61–90 have daily coinsurance, and days 91+ draw on lifetime reserve days.
- [Emergency Room Visits](https://nhqualitycampaign.org/medicare/coverage/emergency-room/) — ER visits that don't result in admission are covered under Part B (20% coinsurance after deductible). If admitted, the visit is billed under Part A.
- [Foreign Travel Emergencies](https://nhqualitycampaign.org/medicare/coverage/foreign-travel/) — Original Medicare generally does not cover care outside the US. Medigap Plans C, D, F, G, M, and N include foreign travel emergency coverage (80% after a $250 deductible, $50,000 lifetime max).
- [Second Medical Opinions](https://nhqualitycampaign.org/medicare/coverage/second-opinion/) — Medicare covers second opinions before surgery. If the first and second opinions differ, Medicare also covers a third.
- [Telehealth Visits](https://nhqualitycampaign.org/medicare/coverage/telehealth/) — Medicare covers a wide range of telehealth services, with permanent coverage for behavioral/mental health and extended flexibilities for primary and specialty care.

## Glossary

- [Medicare Part A](https://nhqualitycampaign.org/glossary/part-a/) — Hospital insurance that covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Premium-free for most who paid Medicare taxes for at least 10 years.
- [Medicare Part B](https://nhqualitycampaign.org/glossary/part-b/) — Medical insurance that covers doctor visits, outpatient care, preventive services, and durable medical equipment. Requires monthly premium ($174.70 standard in 2024).
- [Medicare Part C](https://nhqualitycampaign.org/glossary/part-c/) — Also known as Medicare Advantage. Private plans approved by Medicare that bundle Part A, Part B, and usually Part D coverage, often with extra benefits.
- [Medicare Part D](https://nhqualitycampaign.org/glossary/part-d/) — Prescription drug coverage sold by private insurers approved by Medicare. Includes a formulary (drug list) and coverage phases.
- [Medigap](https://nhqualitycampaign.org/glossary/medigap/) — Medicare Supplement Insurance. Private standardized policies (Plans A–N) that pay some or all out-of-pocket costs left by Original Medicare.
- [Original Medicare](https://nhqualitycampaign.org/glossary/original-medicare/) — The federal fee-for-service program consisting of Part A and Part B. An alternative to Medicare Advantage.
- [Medicare Advantage](https://nhqualitycampaign.org/glossary/medicare-advantage/) — Another name for Medicare Part C; private plans that replace Original Medicare while still providing all Part A and B benefits.
- [Initial Enrollment Period (IEP)](https://nhqualitycampaign.org/glossary/iep/) — A 7-month window around your 65th birthday during which you first enroll in Medicare: 3 months before, your birth month, and 3 months after.
- [Annual Election Period (AEP)](https://nhqualitycampaign.org/glossary/aep/) — October 15 through December 7 each year, when you can switch between Original Medicare and Advantage, change MA plans, or change Part D plans.
- [General Enrollment Period](https://nhqualitycampaign.org/glossary/gep/) — January 1 through March 31 each year, for people who missed IEP without creditable coverage. Late enrollment penalties may apply.
- [Special Enrollment Period (SEP)](https://nhqualitycampaign.org/glossary/sep/) — A window outside normal enrollment periods triggered by qualifying life events like losing employer coverage or moving.
- [Medigap Open Enrollment Period](https://nhqualitycampaign.org/glossary/oep/) — A one-time 6-month window beginning when you are 65+ AND enrolled in Part B. Insurers cannot deny or upcharge for health status during this period.
- [Medicare Advantage Open Enrollment (MA-OEP)](https://nhqualitycampaign.org/glossary/ma-oep/) — January 1 – March 31 each year. Allows one change from Advantage to Original Medicare or to a different Advantage plan.
- [Medigap Plan G](https://nhqualitycampaign.org/glossary/plan-g/) — The most popular Medigap plan for new enrollees. Covers every Medicare gap except the annual Part B deductible.
- [Medigap Plan N](https://nhqualitycampaign.org/glossary/plan-n/) — A lower-premium alternative to Plan G with copays up to $20 for office visits and $50 for ER visits (if not admitted). Does not cover Part B excess charges.
- [Medigap Plan F](https://nhqualitycampaign.org/glossary/plan-f/) — The most comprehensive Medigap plan, closed to anyone who became Medicare-eligible on or after January 1, 2020. Still available to earlier eligibles.
- [High-Deductible Plan G](https://nhqualitycampaign.org/glossary/high-deductible-plan-g/) — A Medigap plan with very low monthly premium but a $2,800 (2024) deductible before full coverage begins.
- [Medigap Plan K](https://nhqualitycampaign.org/glossary/plan-k/) — A cost-sharing Medigap plan that covers 50% of most benefits with an annual out-of-pocket maximum ($7,060 in 2024).
- [Medigap Plan L](https://nhqualitycampaign.org/glossary/plan-l/) — A cost-sharing Medigap plan that covers 75% of most benefits with an annual out-of-pocket maximum ($3,530 in 2024).
- [Part B Excess Charges](https://nhqualitycampaign.org/glossary/part-b-excess-charges/) — Up to 15% above the Medicare-approved amount that non-participating providers can bill. Eight states ban them entirely.
- [Medicare Assignment](https://nhqualitycampaign.org/glossary/assignment/) — When a provider agrees to accept the Medicare-approved amount as full payment for covered services. Most providers accept assignment.
- [Participating Provider](https://nhqualitycampaign.org/glossary/participating-provider/) — A provider who accepts Medicare assignment on all claims.
- [Non-Participating Provider](https://nhqualitycampaign.org/glossary/non-participating-provider/) — A provider who accepts Medicare but may bill up to 15% above the Medicare-approved amount (Part B excess charges).
- [Opt-Out Provider](https://nhqualitycampaign.org/glossary/opt-out-provider/) — A provider who has formally opted out of Medicare. Services from opt-out providers are generally not covered.
- [Formulary](https://nhqualitycampaign.org/glossary/formulary/) — The list of drugs covered by a Part D plan, typically organized into tiers with different cost-sharing.
- [Drug Tier](https://nhqualitycampaign.org/glossary/tier/) — Categories on a Part D formulary (e.g., preferred generic, generic, preferred brand, non-preferred) with increasing cost-sharing.
- [Step Therapy](https://nhqualitycampaign.org/glossary/step-therapy/) — A cost-management tool requiring a patient to try a lower-cost medication before the plan covers a more expensive one.
- [Prior Authorization](https://nhqualitycampaign.org/glossary/prior-authorization/) — Approval that must be obtained from a Medicare Advantage or Part D plan before a covered service or medication.
- [Donut Hole](https://nhqualitycampaign.org/glossary/donut-hole/) — A former coverage gap in Part D. Largely eliminated by the Inflation Reduction Act, which caps out-of-pocket at $2,000 in 2025.
- [Catastrophic Coverage](https://nhqualitycampaign.org/glossary/catastrophic-coverage/) — The Part D stage reached after out-of-pocket spending hits a threshold. The $2,000 cap effectively replaces the traditional catastrophic structure in 2025.
- [Low-Income Subsidy (Extra Help)](https://nhqualitycampaign.org/glossary/lis/) — A federal program that helps pay Part D premiums, deductibles, and copays for enrollees with limited income and resources.
- [Medicare Savings Programs (MSP)](https://nhqualitycampaign.org/glossary/msp/) — State-administered programs that help pay Medicare premiums and cost-sharing for low-income beneficiaries (QMB, SLMB, QI).
- [Qualified Medicare Beneficiary (QMB)](https://nhqualitycampaign.org/glossary/qmb/) — The most comprehensive MSP; pays Part A and B premiums and all Medicare cost-sharing for eligible low-income beneficiaries.
- [Specified Low-Income Medicare Beneficiary (SLMB)](https://nhqualitycampaign.org/glossary/slmb/) — An MSP that pays only the Part B premium for eligible enrollees.
- [Qualifying Individual (QI)](https://nhqualitycampaign.org/glossary/qi/) — An MSP that pays the Part B premium for enrollees slightly above SLMB income limits.
- [IRMAA](https://nhqualitycampaign.org/glossary/irmaa/) — Income-Related Monthly Adjustment Amount. Surcharges on Parts B and D premiums for higher-income beneficiaries, based on MAGI from 2 years prior.
- [Modified Adjusted Gross Income (MAGI)](https://nhqualitycampaign.org/glossary/magi/) — AGI plus certain additions such as tax-exempt interest. Used to calculate IRMAA.
- [Benefit Period](https://nhqualitycampaign.org/glossary/benefit-period/) — The way Medicare measures your use of inpatient hospital and SNF services. Begins with admission and ends after 60 consecutive days without inpatient care.
- [Lifetime Reserve Days](https://nhqualitycampaign.org/glossary/lifetime-reserve-days/) — 60 additional days of inpatient hospital coverage beyond 90 days per benefit period. Once used, they're gone forever.
- [Skilled Nursing Facility (SNF)](https://nhqualitycampaign.org/glossary/snf/) — A facility providing skilled nursing or rehab. Medicare covers up to 100 days per benefit period after a qualifying 3-day hospital stay.
- [CMS](https://nhqualitycampaign.org/glossary/cms/) — Centers for Medicare & Medicaid Services. The federal agency that administers Medicare and partners with states on Medicaid.
- [AHRQ](https://nhqualitycampaign.org/glossary/ahrq/) — Agency for Healthcare Research and Quality. A federal agency producing evidence-based quality and safety research.
- [SHIP](https://nhqualitycampaign.org/glossary/ship/) — State Health Insurance Assistance Program. Free, unbiased Medicare counseling in every state.
- [Long-Term Care Ombudsman](https://nhqualitycampaign.org/glossary/ombudsman/) — A state-based advocate for residents of nursing homes and assisted living facilities.
- [Five-Star Quality Rating](https://nhqualitycampaign.org/glossary/five-star-rating/) — CMS's star rating system (1–5) for nursing homes, hospitals, and Medicare Advantage plans based on quality measures.
- [Minimum Data Set (MDS)](https://nhqualitycampaign.org/glossary/mds/) — A standardized clinical assessment completed on all nursing home residents, used for care planning and Medicare billing.
- [Payroll-Based Journal (PBJ)](https://nhqualitycampaign.org/glossary/pbj/) — CMS system that collects nursing home staffing data from payroll records; used in the Five-Star staffing rating.
- [Home and Community-Based Services (HCBS)](https://nhqualitycampaign.org/glossary/hcbs/) — Medicaid waiver services that deliver long-term care in home or community settings instead of institutions.
- [Activities of Daily Living (ADLs)](https://nhqualitycampaign.org/glossary/adls/) — Basic self-care tasks: bathing, dressing, toileting, transferring, continence, and eating.
- [Instrumental Activities of Daily Living (IADLs)](https://nhqualitycampaign.org/glossary/iadls/) — Complex tasks like managing finances, medications, cooking, transportation, and housework.
- [Homebound](https://nhqualitycampaign.org/glossary/homebound/) — A Medicare criterion requiring that leaving home is a considerable and taxing effort. Required for Medicare home health coverage.
- [Plan of Care](https://nhqualitycampaign.org/glossary/plan-of-care/) — A physician-signed order required for Medicare home health or hospice, reviewed every 60 days.
- [Home Health Aide (HHA)](https://nhqualitycampaign.org/glossary/hha/) — A paraprofessional who provides personal care; covered by Medicare only when combined with a skilled need.
- [Hospice Election](https://nhqualitycampaign.org/glossary/hospice-election/) — Formally choosing the Medicare hospice benefit. Election waives curative treatment for the terminal condition.
- [Durable Medical Equipment (DME)](https://nhqualitycampaign.org/glossary/dme/) — Equipment prescribed for medical use at home — walkers, wheelchairs, CPAP, oxygen.
- [End-Stage Renal Disease (ESRD)](https://nhqualitycampaign.org/glossary/esrd/) — Permanent kidney failure requiring dialysis or transplant. Qualifies people under 65 for Medicare.
- [ALS (Lou Gehrig's Disease)](https://nhqualitycampaign.org/glossary/als/) — Amyotrophic lateral sclerosis. A condition that grants immediate Medicare eligibility upon SSDI approval.
- [Social Security Disability Insurance (SSDI)](https://nhqualitycampaign.org/glossary/ssdi/) — Federal disability benefit. Medicare eligibility begins after 24 months of SSDI entitlement (immediate for ALS).
- [Creditable Coverage](https://nhqualitycampaign.org/glossary/creditable-coverage/) — Drug coverage at least as good as Part D's standard benefit. Required to avoid the Part D late enrollment penalty.
- [Late Enrollment Penalty](https://nhqualitycampaign.org/glossary/leps/) — A permanent premium surcharge added for delaying Medicare enrollment without creditable coverage (Part B: 10% per 12 months; Part D: 1% per month).
- [Guaranteed Issue Right](https://nhqualitycampaign.org/glossary/guaranteed-issue/) — A right to buy certain Medigap policies without health underwriting — for example, during the Medigap OEP or when losing certain coverage.
- [Medical Underwriting](https://nhqualitycampaign.org/glossary/medical-underwriting/) — The process by which insurers evaluate health to decide whether to cover you and at what price. Applies to Medigap outside OEP and guaranteed-issue situations.
- [Medigap Birthday Rule](https://nhqualitycampaign.org/glossary/birthday-rule/) — State-specific rules (CA, OR, NV, IL, LA, ID, OK, WA) allowing annual Medigap plan changes without underwriting in a window around your birthday.
- [OCGHA](https://nhqualitycampaign.org/glossary/ocgha/) — Out-of-country/global health assistance — see "foreign travel emergency" in Medigap plans C, D, F, G, M, N.
- [Service Area](https://nhqualitycampaign.org/glossary/service-area/) — The geographic region where a Medicare Advantage or Part D plan operates. Moving out can trigger a Special Enrollment Period.
- [HMO](https://nhqualitycampaign.org/glossary/hmo/) — Health Maintenance Organization. Network-only except for emergencies; typically requires PCP referrals for specialists.
- [PPO](https://nhqualitycampaign.org/glossary/ppo/) — Preferred Provider Organization. Network preferred but out-of-network services are covered at higher cost.
- [PFFS](https://nhqualitycampaign.org/glossary/pffs/) — Private Fee-for-Service. A less common MA plan type that pays providers a Medicare-like fee schedule.
- [Special Needs Plan (SNP)](https://nhqualitycampaign.org/glossary/snp/) — A Medicare Advantage plan tailored to specific populations: dual-eligibles (D-SNP), chronic conditions (C-SNP), or institutional residents (I-SNP).
- [Maximum Out-of-Pocket (MOOP)](https://nhqualitycampaign.org/glossary/moop/) — An annual cap on what you pay for covered services in a Medicare Advantage plan. In-network MOOP is set by CMS; combined MOOP applies to PPOs.
- [Formulary Exception](https://nhqualitycampaign.org/glossary/formulary-exception/) — A request to have a non-formulary drug covered, or to waive utilization management, based on medical necessity.
- [Medication Therapy Management (MTM)](https://nhqualitycampaign.org/glossary/mtm/) — A Part D program providing comprehensive medication review for enrollees meeting cost or chronic-condition criteria.
- [Medicare Appeal](https://nhqualitycampaign.org/glossary/appeal/) — A formal request to reconsider a coverage or payment decision. Five levels exist, starting with redetermination.
- [Redetermination](https://nhqualitycampaign.org/glossary/redetermination/) — The first level of Medicare appeals, filed with the Medicare Administrative Contractor (MAC) or plan.
- [Administrative Law Judge (ALJ)](https://nhqualitycampaign.org/glossary/alj/) — The third level of Medicare appeals. Independent review with a hearing, for amounts in controversy above the threshold.
- [Medicare Secondary Payer (MSP)](https://nhqualitycampaign.org/glossary/msp-tpl/) — Rules that determine when Medicare pays second to another insurer (e.g., employer coverage, workers' comp).
- [COBRA](https://nhqualitycampaign.org/glossary/cobra/) — Continuation of employer coverage after job loss. Not creditable coverage for Part B — enroll in Medicare at 65 regardless of COBRA.
- [Employer Group Health Plan](https://nhqualitycampaign.org/glossary/employer-coverage/) — Active employment coverage that can delay Part B enrollment without penalty if the employer has 20+ employees.
- [Dual-Eligible](https://nhqualitycampaign.org/glossary/dual-eligible/) — A beneficiary enrolled in both Medicare and Medicaid. Often qualifies for D-SNPs with extra benefits.
- [Medicaid](https://nhqualitycampaign.org/glossary/medicaid/) — A joint federal-state program providing health coverage for eligible low-income Americans, including long-term custodial care that Medicare does not cover.
- [Medicaid Look-Back Period](https://nhqualitycampaign.org/glossary/look-back/) — 60 months before a Medicaid long-term care application when asset transfers are reviewed. Improper transfers trigger a penalty period.
- [Medicaid Spend-Down](https://nhqualitycampaign.org/glossary/spend-down/) — Reducing assets to meet Medicaid eligibility thresholds, typically through care costs or allowed expenditures.
- [Spousal Impoverishment Rules](https://nhqualitycampaign.org/glossary/spousal-impoverishment/) — Medicaid rules that protect a community spouse's income and assets when the other spouse needs long-term care.
- [Estate Recovery](https://nhqualitycampaign.org/glossary/estate-recovery/) — The process by which states recover Medicaid long-term care costs from a deceased beneficiary's estate.
- [Long-Term Care Insurance](https://nhqualitycampaign.org/glossary/ltc-insurance/) — Private insurance that pays a daily benefit toward long-term care expenses when you can't perform 2+ ADLs or have cognitive impairment.
- [Hybrid LTC Policy](https://nhqualitycampaign.org/glossary/hybrid-ltc/) — Life insurance or annuity with an LTC rider — avoids "use it or lose it" risk of traditional LTC insurance.
- [LTC Partnership Program](https://nhqualitycampaign.org/glossary/partnership-policy/) — State-federal program allowing qualified LTC policy holders to protect assets equal to policy benefits paid when applying for Medicaid.
- [VA Aid & Attendance](https://nhqualitycampaign.org/glossary/aid-attendance/) — A VA pension benefit for wartime veterans and surviving spouses who need help with daily activities.
- [TRICARE for Life](https://nhqualitycampaign.org/glossary/tricare-for-life/) — Secondary coverage for Medicare-eligible military retirees and family. Pays after Medicare.
- [CHAMPVA](https://nhqualitycampaign.org/glossary/champva/) — VA health coverage for spouses and dependents of service-connected disabled or deceased veterans.
- [Frailty](https://nhqualitycampaign.org/glossary/frailty/) — A clinical syndrome of reduced reserve and increased vulnerability, often guiding care planning decisions.
- [Delirium](https://nhqualitycampaign.org/glossary/delirium/) — Acute, fluctuating confusion often triggered by illness, medications, or hospitalization. Distinct from dementia.
- [Advance Directive](https://nhqualitycampaign.org/glossary/advance-directive/) — Legal documents expressing your health care preferences if you cannot speak for yourself. Includes living wills and health care proxies.
- [POLST / MOST](https://nhqualitycampaign.org/glossary/polst/) — Physician/Medical Orders for Life-Sustaining Treatment — portable medical orders that travel with a patient.
- [Health Care Power of Attorney](https://nhqualitycampaign.org/glossary/hcpoa/) — A legal document naming a trusted person to make medical decisions on your behalf.
- [Durable Power of Attorney](https://nhqualitycampaign.org/glossary/dpoa/) — A legal document naming someone to handle financial affairs, effective even if you become incapacitated.
- [Fiduciary](https://nhqualitycampaign.org/glossary/fiduciary/) — A person legally obligated to act in another's best interest.
- [Guardianship](https://nhqualitycampaign.org/glossary/guardianship/) — A court-ordered arrangement where a guardian makes decisions for an incapacitated person who lacks legal documents.
- [Elder Law Attorney](https://nhqualitycampaign.org/glossary/elder-law-attorney/) — An attorney specializing in issues affecting older adults — Medicaid planning, estate planning, guardianship, elder abuse.
- [Certified Nurse Assistant (CNA)](https://nhqualitycampaign.org/glossary/cert-nurse-asst/) — A trained and certified direct-care worker in nursing homes and other settings.
- [Licensed Practical Nurse (LPN/LVN)](https://nhqualitycampaign.org/glossary/lpn/) — A nurse licensed to provide basic care under the direction of an RN or physician.
- [Registered Nurse (RN)](https://nhqualitycampaign.org/glossary/rn/) — A nurse licensed to provide comprehensive nursing care. RN staffing hours are a top predictor of nursing home outcomes.
- [Nurse Practitioner (NP)](https://nhqualitycampaign.org/glossary/np/) — An advanced practice nurse who can diagnose, treat, and prescribe within their scope of practice.
- [Physician Assistant (PA)](https://nhqualitycampaign.org/glossary/pa/) — A licensed clinician who practices medicine on a team with physicians.
- [Geriatrician](https://nhqualitycampaign.org/glossary/geriatrician/) — A physician specializing in the care of older adults.
- [Palliative Care](https://nhqualitycampaign.org/glossary/palliative-care/) — Specialized medical care focused on relieving symptoms and stress of serious illness. Can be provided alongside curative treatment.
- [Continuum of Care](https://nhqualitycampaign.org/glossary/continuum-of-care/) — The range of services that help people with progressing needs — home care, assisted living, memory care, skilled nursing, hospice.
- [Continuing Care Retirement Community (CCRC)](https://nhqualitycampaign.org/glossary/ccrc/) — A community offering independent living, assisted living, and skilled nursing on one campus. Often requires substantial entry fee.
- [PACE](https://nhqualitycampaign.org/glossary/pace/) — Program of All-Inclusive Care for the Elderly. Coordinated medical and social care for nursing-home-eligible seniors who can live at home.
- [NAIC](https://nhqualitycampaign.org/glossary/naic/) — National Association of Insurance Commissioners. Model laws from NAIC govern Medigap standardization.
- [MACRA](https://nhqualitycampaign.org/glossary/macra/) — Medicare Access and CHIP Reauthorization Act (2015). Closed Plan F to new enrollees and changed physician payment.
- [Inflation Reduction Act (Medicare provisions)](https://nhqualitycampaign.org/glossary/ira/) — The 2022 law that capped insulin at $35, caps Part D out-of-pocket at $2,000, and allows Medicare drug price negotiation.
- [Accountable Care Organization (ACO)](https://nhqualitycampaign.org/glossary/accountable-care-organization/) — Groups of providers coordinating Medicare care with shared-savings or risk arrangements.
- [ACO REACH](https://nhqualitycampaign.org/glossary/aco-reach/) — A CMS Innovation Center ACO model emphasizing health equity and full-risk options.
- [Medicare Star Ratings](https://nhqualitycampaign.org/glossary/star-ratings/) — CMS's 1-to-5 ratings of Medicare Advantage and Part D plans based on quality and member satisfaction.
- [HEDIS](https://nhqualitycampaign.org/glossary/hedis/) — Healthcare Effectiveness Data and Information Set. Standardized performance measures used in Star Ratings.
- [CAHPS](https://nhqualitycampaign.org/glossary/cahps/) — Consumer Assessment of Healthcare Providers and Systems. Survey-based measures of member experience.
- [Hospital Readmission](https://nhqualitycampaign.org/glossary/readmission/) — A return admission within 30 days of discharge. High readmission rates trigger Medicare payment penalties.
- [Hospital Compare](https://nhqualitycampaign.org/glossary/hospital-compare/) — Medicare.gov tool for comparing hospital quality, safety, and patient experience metrics.
- [Care Compare](https://nhqualitycampaign.org/glossary/care-compare/) — The consolidated Medicare.gov tool covering hospitals, nursing homes, home health, dialysis, rehab, and physicians.
- [ADL Support](https://nhqualitycampaign.org/glossary/adls-support/) — Help with basic self-care tasks, used as a threshold for long-term care insurance and Medicaid benefits.
- [Medical Necessity](https://nhqualitycampaign.org/glossary/medical-necessity/) — The standard requiring services to be reasonable and necessary for diagnosis or treatment. Coverage denials often cite this.
- [Advance Beneficiary Notice (ABN)](https://nhqualitycampaign.org/glossary/noncoverage-notice/) — A written notice a provider must give when they believe Medicare may not pay for a service, so you can decide whether to proceed.
- [Assignment of Benefits](https://nhqualitycampaign.org/glossary/assignment-of-benefits/) — Your authorization for Medicare to pay the provider directly for a claim.
- [Benefit Period Reset](https://nhqualitycampaign.org/glossary/benefit-period-reset/) — When 60 consecutive days pass without inpatient care, a new benefit period begins — a new Part A deductible applies.
- [Lifetime Hospital Psychiatric Limit](https://nhqualitycampaign.org/glossary/lifetime-limit/) — A 190-day lifetime cap on inpatient psychiatric hospital stays under Part A.
- [Skilled Need](https://nhqualitycampaign.org/glossary/skilled-need/) — A requirement for Medicare home health or SNF coverage — daily skilled nursing or therapy ordered by a physician.
- [Observation Status](https://nhqualitycampaign.org/glossary/observation-status/) — An outpatient designation at a hospital that does not count toward the 3-day inpatient qualifier for SNF coverage.
- [RUG / PDPM](https://nhqualitycampaign.org/glossary/rug/) — Resource Utilization Groups (now replaced by Patient-Driven Payment Model): Medicare's SNF billing classification system.
- [Home Modifications](https://nhqualitycampaign.org/glossary/home-modifications/) — Changes to a home for safety — grab bars, ramps, stair lifts. Not covered by Original Medicare; some MA plans cover via supplemental benefits.
- [Personal Emergency Response System (PERS)](https://nhqualitycampaign.org/glossary/personal-emergency-response/) — A wearable alert device that summons help on button press or fall detection.
- [Caregiver](https://nhqualitycampaign.org/glossary/caregiver/) — A family member, friend, or hired professional who provides care for a person who needs help.
- [Respite Care](https://nhqualitycampaign.org/glossary/respite-care/) — Short-term care that gives primary caregivers a break. Covered under Medicare hospice up to 5 consecutive days.
- [Adult Day Services](https://nhqualitycampaign.org/glossary/adult-day/) — Programs providing daytime care for older adults, offering socialization, meals, and activities.
- [Aging-in-Place Village](https://nhqualitycampaign.org/glossary/village/) — A community-based membership organization that helps older adults stay in their homes with volunteer and paid services.
- [Annual Wellness Visit (AWV)](https://nhqualitycampaign.org/glossary/awv/) — A Medicare-covered yearly visit to create or update a personalized prevention plan — not the same as a physical exam.
- [Welcome to Medicare Visit](https://nhqualitycampaign.org/glossary/welcome-visit/) — A one-time preventive visit within the first 12 months of Part B enrollment.
- [Intensive Behavioral Therapy for Obesity](https://nhqualitycampaign.org/glossary/bmi-counseling/) — Up to 14 face-to-face counseling visits for enrollees with BMI ≥30, covered by Medicare.
- [Part B Drug](https://nhqualitycampaign.org/glossary/iv-drug/) — Drugs administered in a medical setting (e.g., infusions, injections by provider) — covered under Part B, not Part D.
- [Self-Administered Drug](https://nhqualitycampaign.org/glossary/self-administered/) — A drug you take yourself (oral, self-injection) — typically covered under Part D, not Part B.
- [Beneficiary](https://nhqualitycampaign.org/glossary/bnef-beneficiary/) — A person enrolled in Medicare benefits.
- [QI Allotment](https://nhqualitycampaign.org/glossary/qi-allotment/) — The limited annual federal funding for Qualifying Individual MSP enrollment, distributed first-come first-served by states.
- [48-Month Medicaid LTC Certification](https://nhqualitycampaign.org/glossary/reqmt-48-month/) — Some state Medicaid programs use 48- or 60-month look-backs for long-term care eligibility review.
- [Miller Trust (QIT)](https://nhqualitycampaign.org/glossary/miller-trust/) — A Qualified Income Trust used in income-cap states so that Medicaid applicants with excess income can qualify.
- [Medigap Plan Switch](https://nhqualitycampaign.org/glossary/supplement-plan-switch/) — Changing Medigap plans or carriers. Requires underwriting outside of OEP, guaranteed-issue, or state birthday/anniversary rules.
- [First-Dollar Coverage](https://nhqualitycampaign.org/glossary/first-dollar/) — Coverage that begins paying from the first dollar of expense. Medigap Plan F is a historical example; MACRA 2015 ended first-dollar Medigap for new eligibles.
- [Medicare Plan Finder](https://nhqualitycampaign.org/glossary/medicare-plan-finder/) — The official Medicare.gov tool to compare Medicare Advantage and Part D plans by ZIP code and drug list.
- [eHealth Medicare](https://nhqualitycampaign.org/glossary/ehealth/) — A licensed online Medicare brokerage offering plan comparison and enrollment.
- [Boomer Benefits](https://nhqualitycampaign.org/glossary/boomer-benefits/) — A well-known licensed Medigap brokerage providing year-round service.
- [GoHealth](https://nhqualitycampaign.org/glossary/gohealth/) — An online Medicare marketplace and call-center brokerage.
- [SelectQuote Senior](https://nhqualitycampaign.org/glossary/selectquote/) — An insurance brokerage that sells Medicare plans and Medigap policies from multiple carriers.
- [Open Enrollment End Date](https://nhqualitycampaign.org/glossary/open-enrollment-end/) — December 7 is the end of the Annual Election Period each year. Changes made during AEP take effect January 1.
- [Plan Disenrollment](https://nhqualitycampaign.org/glossary/enrollment-cancellation/) — Leaving a Medicare Advantage or Part D plan. Allowed only during specific windows (AEP, MA-OEP, SEPs).
- [IRAs and Medicaid](https://nhqualitycampaign.org/glossary/iras-medicaid/) — Whether an IRA counts toward Medicaid LTC asset limits depends on the state and whether it is in payout status.
- [Home Equity Limits (Medicaid)](https://nhqualitycampaign.org/glossary/home-equity/) — Federal caps on home equity that allow Medicaid LTC eligibility ($688,000 or $1,033,000 in 2023 depending on state election).
- [Five-Year Look-Back](https://nhqualitycampaign.org/glossary/five-year-lookback/) — The standard 60-month Medicaid LTC asset transfer review period.
- [Sibling Caregiver Exception](https://nhqualitycampaign.org/glossary/sibling-caregiver-exception/) — A Medicaid rule allowing transfer of a home to a sibling caregiver without penalty under certain conditions.
- [Caregiver Child Exception](https://nhqualitycampaign.org/glossary/caregiver-child-exception/) — A Medicaid rule allowing transfer of a home to an adult child who provided care for 2+ years without penalty.

## Part D Deep Dive

- [Part D Formulary Tiers Explained](https://nhqualitycampaign.org/medicare/part-d/formulary-tiers/) — Part D formularies are organized into tiers — typically 5: preferred generic, generic, preferred brand, non-preferred brand, and specialty. Each tier has different cost-sharing; moving up tiers means higher copays or coinsurance.
- [The Part D Donut Hole in 2026](https://nhqualitycampaign.org/medicare/part-d/donut-hole/) — The coverage gap (donut hole) has been largely eliminated. Under the Inflation Reduction Act, Part D enrollees now have a $2,000 annual out-of-pocket cap that absorbs what the donut hole used to do.
- [$35 Insulin Cap for Medicare](https://nhqualitycampaign.org/medicare/part-d/insulin-35-cap/) — Medicare caps insulin copays at $35 per month per covered insulin under all Part D plans and for insulin used with a covered insulin pump under Part B, since 2023.
- [Part D Vaccines at $0 Cost](https://nhqualitycampaign.org/medicare/part-d/vaccine-zero-cost/) — Since 2023, all ACIP-recommended vaccines under Part D — including Shingrix, Tdap, Hepatitis A, and RSV — are covered at $0 cost.
- [Extra Help (Low-Income Subsidy)](https://nhqualitycampaign.org/medicare/part-d/extra-help-lis/) — Extra Help pays Part D premiums, deductibles, and copays for enrollees with limited income and resources. Eligibility expanded in 2024 — income up to 150% of FPL now qualifies.
- [Part D Late Enrollment Penalty](https://nhqualitycampaign.org/medicare/part-d/late-enrollment-penalty/) — If you go 63+ days without creditable drug coverage after becoming eligible, you pay a permanent penalty of 1% of the national base beneficiary premium per month without coverage.
- [Part D Prior Authorization](https://nhqualitycampaign.org/medicare/part-d/prior-authorization/) — Part D plans require prior authorization for certain drugs — typically expensive biologics, controlled substances, or drugs with safety concerns. Your doctor must submit justification.
- [Step Therapy in Part D](https://nhqualitycampaign.org/medicare/part-d/step-therapy/) — Step therapy requires trying lower-cost medications before the plan covers more expensive ones. Your doctor can request a step therapy exception if the preferred drug isn't appropriate.
- [Part D Quantity Limits](https://nhqualitycampaign.org/medicare/part-d/quantity-limits/) — Quantity limits cap how much medication you can get per fill — typically based on FDA labeling or safety guidelines. Your doctor can request an exception for medically necessary higher amounts.
- [Part D Mail-Order Pharmacy](https://nhqualitycampaign.org/medicare/part-d/mail-order-pharmacy/) — Most Part D plans offer mail-order at lower cost than retail for 90-day fills of maintenance medications.
- [Preferred vs Standard Pharmacies](https://nhqualitycampaign.org/medicare/part-d/preferred-pharmacy/) — Preferred pharmacies in your Part D plan offer lower cost-sharing than standard in-network pharmacies. The distinction is most relevant on Tiers 1 and 2.
- [Part D Specialty Tier Drugs](https://nhqualitycampaign.org/medicare/part-d/specialty-tier/) — Specialty tier drugs treat complex or rare conditions (MS, cancer, HIV, hepatitis) and have drug costs above a set threshold. Cost-sharing is typically 25–33% coinsurance until the annual OOP cap.
- [Medicare Drug Price Negotiation](https://nhqualitycampaign.org/medicare/part-d/drug-price-negotiation/) — The Inflation Reduction Act allows Medicare to negotiate prices for select high-cost Part B and Part D drugs. The first 10 negotiated prices take effect in 2026.
- [Standalone Part D vs MA-PD](https://nhqualitycampaign.org/medicare/part-d/part-d-vs-ma-pd/) — Standalone Part D attaches to Original Medicare; MA-PD is Medicare Advantage with drug coverage bundled. Pricing, formularies, and utilization management can differ between the two.
- [How to Appeal a Part D Denial](https://nhqualitycampaign.org/medicare/part-d/part-d-appeal/) — Part D appeals have five levels, starting with a plan redetermination request. You can request exceptions for non-formulary drugs or lower cost-sharing.
- [Switching Part D Plans](https://nhqualitycampaign.org/medicare/part-d/part-d-switch/) — You can switch Part D plans during AEP (Oct 15 – Dec 7), during MA-OEP (Jan 1 – Mar 31 for MA-PD changes), or with a Special Enrollment Period.
- [Part D for Veterans with VA Drug Coverage](https://nhqualitycampaign.org/medicare/part-d/part-d-for-veterans/) — VA drug coverage is considered creditable for Part D. You can maintain VA coverage without penalty even if you skip Part D, or have both to expand access.
- [What Drugs Are Covered Under Part D](https://nhqualitycampaign.org/medicare/part-d/covered-drugs/) — Part D covers self-administered prescription medications including most brand, generic, and specialty drugs. Excluded categories include over-the-counter drugs, fertility, cosmetics, and some weight-loss drugs (though this is changing).
- [What Counts as Creditable Coverage](https://nhqualitycampaign.org/medicare/part-d/creditable-coverage/) — Creditable drug coverage is as good as or better than standard Part D. Creditable coverage from an employer, VA, or TRICARE lets you delay Part D without penalty.
- [Using Medicare Plan Finder for Part D](https://nhqualitycampaign.org/medicare/part-d/part-d-plan-finder/) — Medicare.gov Plan Finder lets you enter your ZIP code and full drug list to compare Part D premiums, deductibles, and total annual cost across all available plans.

## Best Of Rankings

- [Best Medigap Plan G Carriers](https://nhqualitycampaign.org/best/best-medigap-plan-g-carriers/) — For Plan G, the best carrier depends on your state and age, but four carriers consistently deliver competitive pricing and rate stability nationally: Mutual of Omaha, Cigna, UnitedHealthcare/AARP, and Aetna/Accendo.
- [Best Part D Plans for 2026](https://nhqualitycampaign.org/best/best-part-d-plans-2026/) — No single "best" Part D plan exists — it depends entirely on your drug list, ZIP, and preferred pharmacy. Use Medicare Plan Finder with your actual drugs each year.
- [Best Medicare Advantage Plans](https://nhqualitycampaign.org/best/best-medicare-advantage-plans/) — Best Medicare Advantage plans vary dramatically by county. Nationally, Kaiser Permanente consistently earns 4-5 stars where available; UnitedHealthcare, Humana, and Aetna compete across most markets.
- [Best Dual-Eligible (D-SNP) Plans](https://nhqualitycampaign.org/best/best-d-snp-plans/) — D-SNPs are Medicare Advantage plans for people on both Medicare and Medicaid. The best depends on your state Medicaid program. Strongest national carriers: UnitedHealthcare Dual Complete, Humana D-SNP, Molina Dual Options.
- [Best Medicare Strategy for Veterans](https://nhqualitycampaign.org/best/best-medicare-for-veterans/) — Most Medicare-eligible veterans keep VA health coverage and add Medicare Part A at age 65. Part B is optional but recommended for flexibility outside VA facilities. TRICARE for Life eligible veterans get low-cost secondary coverage.
- [Best Medicare for Low-Income Beneficiaries](https://nhqualitycampaign.org/best/best-medicare-for-low-income/) — Low-income beneficiaries benefit most from Medicare Savings Programs (QMB/SLMB/QI) plus Extra Help for Part D, often paired with a D-SNP that coordinates with Medicaid.
- [Best Medicare for Snowbirds](https://nhqualitycampaign.org/best/best-medicare-for-snowbirds/) — Snowbirds (split-residents) usually fare best with Original Medicare + Medigap + Part D — any Medicare provider in any state, no networks, no prior authorization by geography.
- [Best Medicare for Chronic Conditions](https://nhqualitycampaign.org/best/best-medicare-for-chronic-conditions/) — For people with diabetes, CHF, COPD, or other chronic conditions, Original Medicare + Medigap typically minimizes out-of-pocket. Chronic-condition SNPs (C-SNPs) are another option if your condition qualifies.
- [Best Medicare Plans in California](https://nhqualitycampaign.org/best/best-medicare-california/) — California bans Part B excess charges and has very competitive Medigap and Medicare Advantage markets. Plan G from Mutual of Omaha, UHC, or Accendo often leads; Kaiser Permanente dominates Advantage.
- [Best Medicare Plans in Florida](https://nhqualitycampaign.org/best/best-medicare-florida/) — Florida has the largest Medicare Advantage market in the country. Best Advantage carriers: Humana Gold Plus, UnitedHealthcare, Aetna. For Medigap, focus on rate stability — Florida's large senior population drives competitive pricing.
- [Best Medicare Plans in Texas](https://nhqualitycampaign.org/best/best-medicare-texas/) — Texas has 4.4M Medicare enrollees and a 50% Advantage penetration rate. Strong national carriers (UHC, Humana, Wellpoint) dominate; Blue Cross Blue Shield of Texas anchors the Medigap market.
- [Best Medicare Plans in New York](https://nhqualitycampaign.org/best/best-medicare-new-york/) — New York mandates community-rated Medigap and bans Part B excess charges — but has the highest Medigap premiums in the US. Focus on rate stability and Part B deductible exposure.
- [Best Medigap at Age 65 (Open Enrollment)](https://nhqualitycampaign.org/best/best-medigap-for-age-65/) — Age 65 is when you have the strongest pricing and no health underwriting. Focus on rate stability: community-rated or attained-age plans from A+/A+ AM Best carriers tend to age best.
- [Best Medigap at Age 75+](https://nhqualitycampaign.org/best/best-medigap-for-age-75/) — If you're 75+ and still need Medigap, underwriting is your biggest challenge. Community-rated or issue-age plans from strong carriers are ideal; birthday-rule states let you switch yearly without underwriting.
- [Best Medicare for Frequent Travelers](https://nhqualitycampaign.org/best/best-medicare-for-traveling/) — Frequent travelers need any-provider access. Original Medicare + Medigap Plan G (or F for legacy-eligible) plus Part D gives nationwide access and 80% foreign emergency coverage via Medigap.

## Medicaid Long-Term Care

- [Medicaid Long-Term Care Eligibility](https://nhqualitycampaign.org/medicaid/eligibility-overview/) — Medicaid LTC eligibility requires meeting both a medical threshold (nursing-home level of care) and strict financial thresholds (income and asset limits). Rules vary by state.
- [5-Year Medicaid Look-Back](https://nhqualitycampaign.org/medicaid/look-back-period/) — Medicaid reviews 60 months of asset transfers before an LTC application. Improper transfers create a penalty period of ineligibility equal to the transfer amount divided by the state's average monthly nursing home cost.
- [Spousal Impoverishment Protection](https://nhqualitycampaign.org/medicaid/spousal-impoverishment/) — When one spouse needs Medicaid LTC, spousal impoverishment rules protect the community spouse's income and assets — typically half of countable assets up to a federal maximum ($154,140 in 2024).
- [Medicaid Estate Recovery](https://nhqualitycampaign.org/medicaid/estate-recovery/) — After a Medicaid LTC recipient dies, states must attempt to recover long-term care costs from the estate. The primary residence is often the main recoverable asset.
- [Miller Trusts (Qualified Income Trusts)](https://nhqualitycampaign.org/medicaid/miller-trust/) — In income-cap states (about 22), applicants with income above the Medicaid limit can create a Miller Trust — a Qualified Income Trust — to redirect excess income and qualify for LTC Medicaid.
- [Caregiver Child Exception](https://nhqualitycampaign.org/medicaid/caregiver-child-exception/) — A home transfer to an adult child who lived in the home and provided care that delayed institutionalization for at least 2 years is exempt from Medicaid look-back penalty.
- [Sibling Caregiver Exception](https://nhqualitycampaign.org/medicaid/sibling-exception/) — A home transfer to a sibling with an equity interest who lived in the home 1+ year is exempt from look-back penalty.
- [Irrevocable Trusts for Medicaid Planning](https://nhqualitycampaign.org/medicaid/irrevocable-trusts/) — Assets in a properly structured irrevocable Medicaid Asset Protection Trust (MAPT) can be protected from look-back after the 5-year window.
- [Medicaid Home Equity Limits](https://nhqualitycampaign.org/medicaid/home-equity/) — Federal Medicaid rules allow states to cap home equity at $688,000 or $1,033,000 (2023 figures). Equity above this cap disqualifies an applicant unless a spouse or disabled child lives in the home.
- [Medicaid HCBS Waivers](https://nhqualitycampaign.org/medicaid/hcbs-waivers/) — Home and Community-Based Services (HCBS) waivers let states cover long-term services at home or in assisted living instead of institutional care. Every state has different waiver programs.
- [Medicaid-Compliant Annuities](https://nhqualitycampaign.org/medicaid/annuity-strategy/) — A properly structured single-premium immediate annuity (SPIA) can convert excess assets to income, protect the community spouse, and avoid Medicaid look-back penalty.
- [Medicaid Spend-Down](https://nhqualitycampaign.org/medicaid/spend-down/) — Spend-down is the process of reducing countable assets to meet Medicaid eligibility. Allowed expenditures include care costs, home repairs, prepaid funeral, and medical equipment.
- [Medicaid Income-Cap States](https://nhqualitycampaign.org/medicaid/income-cap-states/) — About 22 states use an income cap for LTC Medicaid eligibility. Applicants with income above the cap must use a Miller Trust to qualify.
- [VA Aid & Attendance for LTC](https://nhqualitycampaign.org/medicaid/veterans-aid-attendance/) — VA Aid & Attendance is a pension benefit for wartime veterans and surviving spouses who need help with daily activities. It can help pay for home care, assisted living, or nursing home.
- [LTC Insurance vs Relying on Medicaid](https://nhqualitycampaign.org/medicaid/long-term-care-insurance-vs-medicaid/) — LTC insurance preserves provider choice and asset flexibility. Medicaid is the safety net but limits care setting, provider network, and forces asset spend-down. Many families use a hybrid approach.

## Life-Event Playbooks

- [What to Do When You Turn 65](https://nhqualitycampaign.org/life-events/turning-65/) — Your 7-month Initial Enrollment Period starts 3 months before you turn 65 and ends 3 months after. Enroll in the first 3 months to avoid coverage gaps.
- [Retiring at 62 — What About Medicare?](https://nhqualitycampaign.org/life-events/retiring-at-62/) — Medicare eligibility starts at 65, not 62. If you retire at 62, you need bridge coverage (ACA Marketplace, COBRA, spouse's plan) until 65.
- [Retiring at 65 With Employer Coverage](https://nhqualitycampaign.org/life-events/retiring-at-65/) — If you're still working at 65 with creditable employer coverage (20+ employee group), you can delay Part B without penalty. You get an 8-month Special Enrollment Period after employment ends.
- [Retiring at 70 After Working Past 65](https://nhqualitycampaign.org/life-events/retiring-at-70/) — If you worked past 65 with employer coverage, your Special Enrollment Period begins when employment or coverage ends — whichever is earlier. Apply for Part B before your last day of work.
- [Losing Employer Health Coverage](https://nhqualitycampaign.org/life-events/losing-employer-coverage/) — When active employment coverage ends, you have an 8-month Special Enrollment Period for Medicare Part B with no late penalty. You also get a 63-day Medigap guaranteed-issue right.
- [Losing Medicaid Coverage](https://nhqualitycampaign.org/life-events/losing-medicaid/) — Losing Medicaid coverage triggers a 3-month Special Enrollment Period for Medicare Part B, Part D, or Medicare Advantage.
- [Moving to a New State](https://nhqualitycampaign.org/life-events/moving-to-new-state/) — Moving to a new state gives you a Special Enrollment Period to change Medicare Advantage plans or drop MA for Original Medicare. SEP lasts 2 full months after the move.
- [Losing a Spouse](https://nhqualitycampaign.org/life-events/losing-spouse/) — Losing a spouse creates emotional and administrative urgency. Update Medicare/Social Security records, check spousal survivor benefits, and review coverage tied to the deceased spouse.
- [Medicare After Divorce](https://nhqualitycampaign.org/life-events/divorce/) — Divorce can affect Medicare eligibility and Medigap pricing but does not usually create a special enrollment right. Review any spousal-tied coverage or benefits.
- [Becoming Newly Eligible for Medicaid](https://nhqualitycampaign.org/life-events/becoming-eligible-for-medicaid/) — Newly gaining Medicaid eligibility triggers automatic Extra Help for Part D and possibly a D-SNP option. You also get a Special Enrollment Period to change MA or Part D plans.
- [Moving Into a Nursing Home](https://nhqualitycampaign.org/life-events/moving-into-nursing-home/) — Moving into a nursing home triggers an ongoing Special Enrollment Period to switch MA or Part D plans and may trigger Medicaid LTC eligibility planning.
- [Moving Out of a Nursing Home](https://nhqualitycampaign.org/life-events/moving-out-of-nursing-home/) — Leaving a nursing home triggers a 2-month Special Enrollment Period to change MA or Part D plans.
- [Becoming Disabled Under 65](https://nhqualitycampaign.org/life-events/becoming-disabled/) — After 24 months of Social Security Disability Insurance (SSDI) entitlement, you automatically receive Medicare. ALS and ESRD provide immediate eligibility.
- [ESRD Diagnosis at Any Age](https://nhqualitycampaign.org/life-events/esrd-diagnosis/) — An ESRD (kidney failure) diagnosis grants Medicare eligibility at any age. Coverage typically begins the first of the 4th month of dialysis, or earlier with home dialysis training.
- [ALS Diagnosis](https://nhqualitycampaign.org/life-events/als-diagnosis/) — An ALS (Lou Gehrig's) diagnosis grants immediate Medicare eligibility upon SSDI approval — no 24-month waiting period.
- [Retiree Health Coverage Ending](https://nhqualitycampaign.org/life-events/retiree-coverage-ending/) — If a former employer ends retiree health coverage, you get a 63-day Medigap guaranteed-issue right for certain plans (C, D, F, G, K, L) if you're already on Medicare.
- [Turning 26 on a Parent's ACA Plan](https://nhqualitycampaign.org/life-events/turning-26-on-parent-plan/) — Age 26 is an ACA aging-out event. You have 60 days before or after your 26th birthday to enroll in a new ACA plan or other coverage.
- [Qualifying for Extra Help (LIS)](https://nhqualitycampaign.org/life-events/qualifying-for-extra-help/) — Newly qualifying for Extra Help triggers a Special Enrollment Period to change Part D plans. Extra Help pays premiums, deductibles, and caps copays.
- [Your Plan Terminates or Changes Service Area](https://nhqualitycampaign.org/life-events/plan-terminates/) — If your Medicare Advantage or Part D plan stops offering coverage or leaves your service area, you get a Special Enrollment Period to choose a new plan.
- [Returning to the US After Living Abroad](https://nhqualitycampaign.org/life-events/returning-from-abroad/) — If you dropped Medicare while living abroad and return, you can use the General Enrollment Period (Jan 1 – Mar 31) with penalties, or a Special Enrollment Period for those who deferred due to foreign residency.
- [Getting Married (Or Remarried)](https://nhqualitycampaign.org/life-events/getting-married/) — Marriage doesn't create a Medicare SEP directly, but it can affect Medigap household discounts, spousal SS benefits, and IRMAA bracket (joint filing).
- [COBRA Ending](https://nhqualitycampaign.org/life-events/lose-cobra-coverage/) — When COBRA ends, you face a 63-day Medigap guaranteed-issue right and a 2-month Part D SEP. COBRA is NOT creditable for Part B — if you delayed Part B for COBRA, you face late penalties.
- [Your Plan's Star Rating Drops](https://nhqualitycampaign.org/life-events/plan-star-rating-drop/) — If your MA plan's star rating drops below 3, CMS may offer a mid-year disenrollment SEP. Low-performing plans are rare but it's worth monitoring.
- [A 5-Star Plan Becomes Available](https://nhqualitycampaign.org/life-events/five-star-plan-available/) — You can switch to a 5-star Medicare Advantage or Part D plan once per year, any time between December 8 and November 30, using the 5-Star SEP.
- [Receiving a Cancer Diagnosis](https://nhqualitycampaign.org/life-events/cancer-diagnosis/) — A cancer diagnosis doesn't trigger a Medicare SEP but may make it critical to review your plan: in-network oncologists, prior authorization patterns, specialty drug coverage, and Medigap gap exposure.
- [Receiving a Dementia Diagnosis](https://nhqualitycampaign.org/life-events/dementia-diagnosis/) — A dementia diagnosis is a pivotal moment for long-term care planning. Establish legal documents early, evaluate coverage, and project long-term care costs.
- [Adult Child Starting to Caregive](https://nhqualitycampaign.org/life-events/adult-child-caregiving/) — Taking on caregiving for an aging parent touches many Medicare and legal issues. Establish power of attorney, understand Medicare coverage, and explore caregiver support programs.
- [Aging Parent Moves in With You](https://nhqualitycampaign.org/life-events/parent-moves-in/) — When a parent moves in, consider home modifications, caregiver services, Medicaid HCBS waivers, and tax dependency rules.
- [Activating Long-Term Care Insurance](https://nhqualitycampaign.org/life-events/receive-long-term-care-policy/) — LTC insurance claims require documentation of dependency (inability to perform 2+ ADLs) or cognitive impairment. Approval may take 30–90 days; many policies have elimination periods.
- [End-of-Life Planning](https://nhqualitycampaign.org/life-events/end-of-life-planning/) — End-of-life planning includes advance directives, hospice election, and estate planning. Medicare covers hospice at $0 for terminal prognosis of 6 months or less.

## Tools & Data
- [Medicare Cost Calculator](https://nhqualitycampaign.org/tools/medicare-cost-calculator/)
- [Medigap Premium Estimator](https://nhqualitycampaign.org/tools/medigap-premium-estimator/)
- [IRMAA Calculator](https://nhqualitycampaign.org/tools/irmaa-calculator/)
- [Enrollment Period Finder](https://nhqualitycampaign.org/tools/enrollment-period-finder/)
- [Nursing Home Cost & Medicaid Burn-Down](https://nhqualitycampaign.org/tools/nursing-home-cost-calculator/)
- [Data Hub](https://nhqualitycampaign.org/data/)